scholarly journals Developing Software to “Track and Catch” Missed Follow-up of Abnormal Test Results in a Complex Sociotechnical Environment

2013 ◽  
Vol 04 (03) ◽  
pp. 359-375 ◽  
Author(s):  
M. Smith ◽  
D. Murphy ◽  
A. Laxmisan ◽  
D. Sittig ◽  
B. Reis ◽  
...  
Keyword(s):  
Formative Evaluation ◽  
Usability Testing ◽  
Test Results ◽  
Clinical Workflow ◽  
Alert Fatigue ◽  
High Workload ◽  
Abnormal Test Result ◽  
Test Result ◽  
Software Prototype

SummaryBackground: Abnormal test results do not always receive timely follow-up, even when providers are notified through electronic health record (EHR)-based alerts. High workload, alert fatigue, and other demands on attention disrupt a provider’s prospective memory for tasks required to initiate follow-up. Thus, EHR-based tracking and reminding functionalities are needed to improve follow-up.Objectives: The purpose of this study was to develop a decision-support software prototype enabling individual and system-wide tracking of abnormal test result alerts lacking follow-up, and to conduct formative evaluations, including usability testing.Methods: We developed a working prototype software system, the Alert Watch And Response Engine (AWARE), to detect abnormal test result alerts lacking documented follow-up, and to present context-specific reminders to providers. Development and testing took place within the VA’s EHR and focused on four cancer-related abnormal test results. Design concepts emphasized mitigating the effects of high workload and alert fatigue while being minimally intrusive. We conducted a multifaceted formative evaluation of the software, addressing fit within the larger socio-technical system. Evaluations included usability testing with the prototype and interview questions about organizational and workflow factors. Participants included 23 physicians, 9 clinical information technology specialists, and 8 quality/safety managers.Results: Evaluation results indicated that our software prototype fit within the technical environment and clinical workflow, and physicians were able to use it successfully. Quality/safety managers reported that the tool would be useful in future quality assurance activities to detect patients who lack documented follow-up. Additionally, we successfully installed the software on the local facility’s “test” EHR system, thus demonstrating technical compatibility.Conclusion: To address the factors involved in missed test results, we developed a software prototype to account for technical, usability, organizational, and workflow needs. Our evaluation has shown the feasibility of the prototype as a means of facilitating better follow-up for cancer-related abnormal test results.

scholarly journals Pelaksanaan Evaluasi Formatif Mata Pelajaran Ekonomi Pada Kelas Xi Di Madrasah Aliyah Al�Badar Kasongan

2014 ◽  
Vol 14 (1) ◽  
pp. 119-129
Author(s):  
Supardi Supardi
Keyword(s):  
Learning Outcomes ◽  
Learning Process ◽  
Formative Evaluation ◽  
Lesson Plans ◽  
Learning System ◽  
Test Results ◽  
Teacher Planning

This study aims to determine the Formative Evaluation of the Implementation of Economic Subjects in class XI in Aliyah Al-Badar Lessons Kasongan academic years 2013-2014. To get the data the researchers used several methods, namely: Interview, observation, and documentation. Planning is the preparation done by teachers in economics before carrying out the formative evaluation, namely to create a syllabus and lesson plans, so that the implementation of formative evaluation can be run properly. Implementation of formative evaluation of economic subjects held in Aliyah Al - Badar is in conformity with the relevant teacher planning, even in the learning system that is taught to students of economic subjects has been going well despite the shortcomings, especially infrastructure and facilities such as libraries, laboratories, and textbooks are very minimal. Follow up of the results of the formative evaluation, after carrying out the formative evaluation of the test results will be notified to the learning outcomes of students who either can continue to the next lesson, but for the students who have not reached the learning outcomes, KKM will be held remedial for improved results. Constraints in the learning process faced by teachers are mastery of the material, therefore the teachers of economics should be ready in the mastery of the material that will be presented to the learner.

Patient groups, clinicians and healthcare professionals agree – all test results need to be seen, understood and followed up

Diagnosis ◽  
2018 ◽  
Vol 5 (4) ◽  
pp. 215-222 ◽  
Author(s):  
Maria R. Dahm ◽  
Andrew Georgiou ◽  
Robert Herkes ◽  
Anthony Brown ◽  
Julie Li ◽  
...  
Keyword(s):  
Patient Safety ◽  
Systems Approach ◽  
Digital Health ◽  
Diagnostic Testing ◽  
Care Process ◽  
Test Results ◽  
Levels Of Care ◽  
Result Management ◽  
Test Result

AbstractBackgroundDiagnostic testing provides integral information for the prevention, diagnosis, treatment and management of disease. Inadequate test result reporting and follow-up is a major risk to patient safety. Factors contributing to failure to follow-up test results include unclear delineation of responsibility about who is meant to act on a test result; poor coordination across different levels of care; and the absence of integrated health information systems for the efficient information communication.MethodsA 2016 Australian Stakeholder Forum brought together over 30 representatives from 14 different consumer, clinical and management stakeholder organisations to discuss safe and effective test result communication, management and follow-up. Thematic analysis was conducted drawing on multimodal data collected in the form of observational fieldnotes and document artefacts produced by participants.ResultsThe forum identified major challenges which pose immediate risks to patient safety. Participants recommended priorities for addressing issues relating to: (i) the governance of test result management processes; (ii) integration of health care processes through the utilisation of effective digital health solutions; and (iii) involving patients as key partners in the decision-making and care process.ConclusionsStakeholder groups diverged slightly in their priorities. Consumers highlighted the lack of patient involvement in the test result management process but were less concerned about standardisation of reports and critical result thresholds than pathologists. The forum foregrounded the need for a systems approach, capable of identifying and addressing interconnections and multiple factors that contribute to poor test result follow-up, with a strong emphasis on enhancing the contribution of patients.

scholarly journals Pelaksanaan Evaluasi Formatif Mata Pelajaran Ekonomi Pada Kelas XI di Madrasah Aliyah Al-Badar Kasongan

2015 ◽  
Vol 14 (2) ◽  
Author(s):  
Endang Sri Suyati
Keyword(s):  
Data Analysis ◽  
Data Collection ◽  
Learning Process ◽  
Formative Evaluation ◽  
Implementation Process ◽  
Qualitative Approach ◽  
Test Results ◽  
Study Results ◽  
Evaluation Test

The approach used is a qualitative approach. To obtain the relevant data is used several methods: 1) interview or interviews, 2) observation, and 3) documentation. The implementation process of data analysis in this research since the beginning of data collection and worked intensively after leaving the field. The data were analyzed by the researchers as soon as possible so that the data obtained are not raw or expired. Analysis of the data include: 1) data reduction, 2) display data, and 3) displays a conclusion and verification. The conclusion of this study are: 1) planning is the preparation of teachers of economics before the formative evaluation, which is to create a syllabus and lesson plans, so that the implementation of the formative evaluation can be run properly, 2) the implementation of the formative evaluation of economic subjects held in Madrasah Aliyah Al-Badr was appropriate the planning of the teacher concerned, 3) follow up the results of the formative evaluation, after carrying out formative evaluation test results will be communicated to students that study results can either continue to the next lesson, but for students who study results have not yet reached KKM will take remedial for repairs the results, 4) the obstacles in the learning process faced by teachers is mastery of the material, because the teachers of economics should be ready in the mastery of the material that will be presented to the learner, 5) the efforts of teachers of economics in the implementation of formative evaluation planning with good.

Significance of High-Risk Human Papillomavirus DNA Detection in Women 50 Years and Older With Squamous Cell Papanicolaou Test Abnormalities

2010 ◽  
Vol 134 (8) ◽  
pp. 1130-1135
Author(s):  
Chengquan Zhao ◽  
Shuping Zhao ◽  
Amer Heider ◽  
R. Marshall Austin
Keyword(s):  
Cervical Intraepithelial Neoplasia ◽  
Intraepithelial Neoplasia ◽  
Test Results ◽  
Squamous Intraepithelial Lesion ◽  
Papanicolaou Test ◽  
Squamous Cells ◽  
Intraepithelial Lesion ◽  
Liquid Based Cytology ◽  
Test Result

Abstract Context.—Data on cytologic screening and follow-up disproportionately reflect findings from frequently screened younger women, and data from screened women 50 years and older using newer screening technologies remain limited. Objective.—To better understand the utility of adjunctive high-risk human papillomavirus (hrHPV) testing for disease risk stratification in women 50 years and older with a range of liquid-based cytology, abnormal, squamous cell Papanicolaou test results. Design.—Liquid-based cytology cases interpreted as high-grade squamous intraepithelial lesion (HSIL); low-grade squamous intraepithelial lesion (LSIL); atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (ASC-H); and atypical squamous cells of undetermined significance (ASC-US) at Magee-Womens Hospital (Pittsburgh, Pennsylvania) were retrospectively identified for a 36-month period between July 1, 2005, and June 30, 2008, from women 50 years and older who also had hrHPV DNA test results. Histopathologic follow-up diagnoses were analyzed. Results.—During the study period, 4855 women 50 years and older had HSIL, LSIL, ASC-H, or ASC-US Papanicolaou test results and hrHPV testing. In 89.3% of HSIL cases, 71.0% of LSIL cases, 38.9% of ASC-H cases, and 14.2% of ASC-US cases, hrHPV test results were positive. The positive predictive value of a positive hrHPV test for histopathologic cervical intraepithelial neoplasia 2/3+ detection was 90.5% with HSIL, 15% with ASC-H, 9.8% with LSIL, and 3.2% with ASC-US. A negative hrHPV test result had a 100% negative predictive value for histopathologic cervical intraepithelial neoplasia 2/3+ in both LSIL and ASC-H cases. Conclusions.—In women 50 years and older, a positive hrHPV test result significantly increased the likelihood of follow-up histopathologic diagnoses of cervical intraepithelial neoplasia 2 /3+ in patients with HSIL, LSIL, and ASC-H Papanicolaou test results compared with women with negative hrHPV test results. No cervical intraepithelial neoplasia 2/3+ diagnoses were documented in women 50 years and older with LSIL or ASC-H Papanicolaou test results and negative hrHPV test results.

scholarly journals Linking acknowledgement to action: closing the loop on non-urgent, clinically significant test results in the electronic health record

2015 ◽  
Vol 22 (4) ◽  
pp. 905-908 ◽  
Author(s):  
Anuj K Dalal ◽  
Bailey M Pesterev ◽  
Katyuska Eibensteiner ◽  
Lisa P Newmark ◽  
Lipika Samal ◽  
...  
Keyword(s):  
Primary Care Physicians ◽  
Safety Concern ◽  
Test Results ◽  
Ambulatory Patient ◽  
Health Records ◽  
Closing The Loop ◽  
Electronic Health ◽  
Clinically Significant ◽  
Test Result

Abstract Failure to follow-up nonurgent, clinically significant test results (CSTRs) is an ambulatory patient safety concern. Tools within electronic health records (EHRs) may facilitate test result acknowledgment, but their utility with regard to nonurgent CSTRs is unclear. We measured use of an acknowledgment tool by 146 primary care physicians (PCPs) at 13 network-affiliated practices that use the same EHR. We then surveyed PCPs to assess use of, satisfaction with, and desired enhancements to the acknowledgment tool. The rate of acknowledgment of non-urgent CSTRs by PCPs was 78%. Of 73 survey respondents, 72 reported taking one or more actions after reviewing a CSTR; fewer (40–75%) reported that using the acknowledgment tool was helpful for a specific purpose. Forty-six (64%) were satisfied with the tool. Both satisfied and nonsatisfied PCPs reported that enhancements linking acknowledgment to routine actions would be useful. EHR vendors should consider enhancements to acknowledgment functionality to ensure follow-up of nonurgent CSTRs.

Dynamic Posturography and Caloric Test Results Patients with and without Vertigo

1989 ◽  
Vol 100 (6) ◽  
pp. 553-558 ◽  
Author(s):  
Joel A. Goebel ◽  
Gary D. Paige
Keyword(s):  
Caloric Test ◽  
Test Results ◽  
Dynamic Posturography ◽  
Caloric Stimulation ◽  
History Of ◽  
Abnormal Test Result ◽  
Test Result

Patients with Dizziness Were Evaluated with Caloric Stimulation and with Dynamic Platform Posturography (Neurocom Equltest). The Ability of These Tests To Detect Abnormalities in Patients with and Without Vertigo Was Assessed. In 159 Patients, roughly a third had abnormal calorics while half experienced one or more “falls” during posturography. Calorics revealed proportionately more abnormalities in patients with vertigo, whereas posturography alone did not distinguish between patients with or without vertigo. Posturography did, however, Identify abnormalities in a third of patients with normal calorics, regardless of their history of vertigo. Overall, more patients with vertigo had at least one abnormal test result (70%) compared with patients without vertigo (47%). We conclude that caloric abnormalities correlate with a history of vertigo, whereas posturographic deficits can be Identified regardless of the presence of vertigo.

scholarly journals Long-Term Follow-Up in Children with Anisocoria: Cocaine Test Results and Patient Outcome

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Fabienne C. Fierz ◽  
Christina Gerth-Kahlert
Keyword(s):  
Pediatric Population ◽  
Horner’S Syndrome ◽  
Surgical Trauma ◽  
Test Results ◽  
Horner's Syndrome ◽  
Tertiary Referral Centre ◽  
Long Term Follow Up ◽  
Test Result

Background. Evaluation of anisocoria including pharmacological testing for Horner’s syndrome in the pediatric population is challenging in view of potential serious underlying disease. We describe cocaine test results, outcome of systemic investigation, and long-term follow-up in children with anisocoria. Methods. Retrospective review of medical records and phone interview of consecutive pediatric patients (<18 years old) who underwent cocaine testing from August 2007 to July 2015 at a tertiary referral centre. Results. A total of 35 patients were included with a positive, negative, or inconclusive cocaine test in 12/35, 19/35, and 4/35, respectively. Systemic investigation was performed in 11 of the patients with a positive and in 2 of the patients with an inconclusive cocaine test result. Mediastinal Hodgkin lymphoma was found in one patient with an inconclusive cocaine test result. Two other cases were presumably related to birth trauma and surgical trauma. None of the other children further developed any pathology during the follow-up period of 34.8 months (range 0–106.6). Conclusions. In most children with anisocoria and a positive cocaine test result, systemic investigation did not reveal any underlying etiology. The only malignant disease was diagnosed in a patient with a suspicion of Horner’s syndrome but with an inconclusive cocaine test result in our cohort.

Usability Testing of Ultrasonic Surgical System for Lower Eyelid Fat Removal

2021 ◽  
Vol 10 (1) ◽  
pp. 251-256
Author(s):  
JeongUk Choi ◽  
SangEun Park ◽  
Wonseuk Jang
Keyword(s):  
User Satisfaction ◽  
Risk Mitigation ◽  
Usability Testing ◽  
Lower Eyelid ◽  
Task Completion ◽  
Test Results ◽  
Subjective Data ◽  
Fat Removal ◽  
Surgical System

This study shows the method and result on usability testing of ultrasonic surgical system for general liposuction & lower eyelid surgery. The purpose of the study is to validate whether UI risk mitigation controls are properly established and collected any opinions about the device. The quantitative data(task completion rate, the number of use error occurred, user satisfaction score) and qualitative data(subjective opinions via follow-up question) were collected. Due to simple how to use, few use errors were occurred. But the result from analyzing subjective data was different, several potential harms causing from the user interface were expected. These test results could help medical device designers to understand human factor considerations.

scholarly journals Variation in electronic test results management and its implications for patient safety: A multisite investigation

2020 ◽  
Vol 27 (8) ◽  
pp. 1214-1224
Author(s):  
Judith Thomas ◽  
Maria R Dahm ◽  
Julie Li ◽  
Peter Smith ◽  
Jacqui Irvine ◽  
...  
Keyword(s):  
Information Technology ◽  
Patient Safety ◽  
Health Information Technology ◽  
Health Information ◽  
Diagnostic Test ◽  
Test Results ◽  
Results Management ◽  
Result Management ◽  
Test Result

Abstract Objective The management and follow-up of diagnostic test results is a major patient safety concern. The aim of this qualitative study was to explore how clinicians manage test results on an everyday basis (work-as-done) in a health information technology–enabled emergency department setting. The objectives were to identify (1) variations in work-as-done in test results management and (2) the strategies clinicians use to ensure optimal management of diagnostic test results. Materials and Methods Qualitative interviews (n = 26) and field observations were conducted across 3 Australian emergency departments. Interview data coded for results management (ie, tracking, acknowledgment, and follow-up), and artifacts, were reviewed to identify variations in descriptions of work-as-done. Thematic analysis was performed to identify common themes. Results Despite using the same test result management application, there were variations in how the system was used. We identified 5 themes relating to electronic test results management: (1) tracking test results, (2) use and understanding of system functionality, (3) visibility of result actions and acknowledgment, (4) results inbox use, and (5) challenges associated with the absence of an inbox for results notifications for advanced practice nurses. Discussion Our findings highlight that variations in work-as-done can function to overcome perceived impediments to managing test results in a HIT-enabled environment and thus identify potential risks in the process. By illuminating work-as-done, we identified strategies clinicians use to enhance test result management including paper-based manual processes, cognitive reminders, and adaptive use of electronic medical record functionality. Conclusions Test results tracking and follow-up is a priority area in need of health information technology development and training to improve team-based collaboration/communication of results follow-up and diagnostic safety.

scholarly journals Cohort profile: Actionable Register of Geneva Outpatients and inpatients with SARS-CoV-2 (ARGOS)

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e048946
Author(s):  
Camille Genecand ◽  
Denis Mongin ◽  
Flora Koegler ◽  
Dan Lebowitz ◽  
Simon Regard ◽  
...  
Keyword(s):  
Public Health ◽  
Demographic Data ◽  
Participation Rate ◽  
Contact Tracing ◽  
Test Results ◽  
Health It ◽  
Public Health Policies ◽  
The Impact ◽  
Test Result

PurposeThe Actionable Register of Geneva Outpatients and inpatients with SARS-CoV-2 (ARGOS) is an ongoing prospective cohort created by the Geneva Directorate of Health. It consists of an operational database compiling all SARS-CoV-2 test results recorded in the Geneva area since late February 2020. This article aims at presenting this comprehensive cohort, in light of some of the varying public health measures in Geneva, Switzerland, since March 2020.ParticipantsAs of 1 June 2021, the database included 360 525 patients, among which 65 475 had at least one positive test result for SARS-CoV-2. Among all positive patients, 37.6% were contacted only once, 10.6% had one follow-up call, 8.5% had two and 27.7% had three or more follow-up calls. Participation rate among positive patients is 94%. Data collection is ongoing.Findings to dateARGOS data illustrates the magnitude of COVID-19 pandemic in Geneva, Switzerland, and details a variety of population factors and outcomes. The content of the cohort includes demographic data, comorbidities and risk factors for poor clinical outcome, self-reported COVID-19 symptoms, environmental and socioeconomic factors, prospective and retrospective contact tracing data, travel quarantine data and deaths. The registry has already been used in several publications focusing on symptoms and long COVID-19, infection fatality rate and re-infection.Future plansThe data of this large real-world registry provides a valuable resource for various types of research, such as clinical research, epidemiological research or policy assessment as it illustrates the impact of public health policies and overall disease burden of COVID-19.

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